Combining a breast lift with implants is indicated if there is an emptiness to your breasts, a droop and a low lying nipple. Typically this might be the result of breast feeding, losing weight or ageing, but on the other hand, some breasts naturally develop in this way. The implant can be used to provide volume to the breast, whilst the lift will tighten the skin and re-position the nipple to a more aesthetic position.
“I frequently perform augmentation mastopexies, and I feel it is important to have a detailed discussion with my patients about why I may be recommending this rather than a breast augmentation alone. Sometimes patients do not expect this recommendation, but after spending time together, and analysing their breasts, it becomes clear why the addition of a breast lift is necessary. In my opinion, breast shape always comes first, before breast size, and this concept is key in planning a breast lift combined with enlargement”
The Breast Augmentation Mastopexy Procedure
Your breasts are lifted and enlarged (using breast implants) in one operation. This is done by removing skin from below and around your nipple, raising your nipple and tightening the breast tissue inside. The skin is then stitched leaving you with a scar around the areola (the coloured skin around the nipple), vertically down from the areola to the crease under the breast and sometimes a horizontal scar underneath the breast along the breast crease.
What does it involve?
The operation is performed under a general anaesthetic (with you asleep). You will wake up with surgical tapes along the wounds and a supportive post-surgical bra following surgery.
What are the benefits?
Augmentation mastopexy techniques provide a breast lift and increase the fullness to the upper part of your breast, and the implant increases the overall size of your breasts.
How long is the surgery?
The surgery takes 2-3 hours.
What is the recovery period?
The procedure requires an overnight stay in hospital after the surgery. This is to ensure that there is only minimal fluid coming into your drains, which may then be removed. You should wear a supportive post-surgical or sports bra day-and-night for at least 6-weeks after surgery, and sometimes for 3-months.
How long before daily activities may be resumed?
Strenuous activity should be avoided for at least 2-weeks. Driving should wait until 3-weeks after the surgery – you need to be comfortable performing an emergency stop or similar manoeuvre. If you drive too early and you need to do an emergency stop, the wounds may come apart.
What are the success rates?
Augmentation mastopexies are challenging operations, but provide good results. Minor revisional surgery is frequently needed to perfect the outcome.
Paitent of Mr Pacifico 2-years following an augmentation mastopexy. 300cc moderate profile round implants were used.
What are the possible complications?
- Wound infection & wound breakdown (most likely at the “T” junction)
- Bleeding or haematoma (a collection of blood in the wound that would mean that you would need to go back to the operating theatre for the bleeding to be stopped)
- Capsular contracture is an important possible complication to be aware of – this refers to tightening of the naturally-forming scar tissue around the implant that may change the shape of the breast or cause discomfort. This would mean further surgery to replace the implant and release the tight scar tissue.
- Lumpy scarring (hypertrophic or keloid scarring) which may be difficult to treat
- Nipple problems, including a change in nipple sensation (usually less sensitive, but occasionally more) and complete or partial loss of your nipple (a rare but important complication)
- Fat necrosis (dying of some areas of fat within the breast) – this either shows as an oily discharge from the wound or as the formation of lumps within the breast. It may mean that you would need to go back to the operating theatre, but can usually be treated as an outpatient with dressings (if the wound has opened) or with massage of any lumps that form within the breast
- Breast asymmetry – no breasts in any woman are identical, and although Mr Pacifico strives to make both sides as equal as possible, there will be differences between them
- Bottoming out – this is the term given to a large part of your breast dropping below the level of the nipple – the effect is to make your nipples appear above your bra. This is an unusual complication
- Deep vein thrombosis (DVT) and pulmonary embolus (PE) – these are blood clots that may occur in the leg (DVT) and travel to the lung (PE) which may be very serious – fortunately they are not common.
- Further surgery may be needed to make adjustments to correct for imperfections or differences between the breasts (may occur in up to 20% of cases)